What is Meant by “Sliding Scale” and How To Talk to Your Therapist About Accessing It

Today’s piece is written by our Community Manager, Kayla. Through her own personal experience with therapy and training in Clinical Psychology, Kayla has developed an awareness of how therapy can be an extraordinarily helpful way to improve our overall health and wellbeing.

Despite its positive impact, Kayla recognizes that the price point of therapy can be difficult to access.

Today, Kayla breaks down what a sliding scale is and how someone can ask for one. A sliding scale is one option for therapy-seekers to access therapy at a lower price than a therapist’s usual fee, based on the seeker’s particular circumstances, and the therapist’s commitment to improve access for those who need it. Read on to learn more.

It is a troubling issue within society at large that people who are experiencing health concerns do not receive the treatment that they need when the cost of treatment is more than they can afford.

When fees are too high, we often revert to wrestling with our concerns on our own, without the guidance and support of a trained professional who is equipped to guide us through a healing process.

In the world of therapy and mental health, access to service remains an ongoing problem, especially since many health insurance companies do not cover fees associated with mental health. Fortunately, there are still a number of ways that clients who are not able to afford full fees for therapy can access the help that they need.

One option is sliding scale.

What is a sliding scale?

A sliding scale is a flexible fee structure, tailored to you and your particular needs. One therapy-goer may pay more or less than another depending on their unique personal circumstances and what they are able to afford.

Need an example? No problem.

A therapist with a private practice may have a full fee of $175 per session, which has been thoughtfully determined, taking into account their unique training, experience, and expertise. This therapist is aware, though, that while their fee is appropriate, it may not be affordable for everybody.

They want the opportunity to connect with clients whose incomes may fall under an amount that makes their full fee affordable, so they decide to offer a sliding scale.

The therapist will keep their full fee $175 per session, but offer sessions at varying rates less than that fee (maybe $100 per session, $125 per session, and $150 per session) depending on a person’s income and what they can afford.

This therapist would come to an agreement with each individual client who is accessing their sliding scale about how much the client will be charged for sessions.

How to talk to your therapist about accessing sliding scale

It is best to ask any therapist you might want to work with what their fee is and what forms of payment they accept during your phone consultation or initial point of contact. It is helpful for the therapeutic process and relationship if both parties are on the same page about payment from the very start of treatment.

If the therapist communicates a full fee that is more than you can afford, ask them at this point if they offer a sliding scale.

If they do offer a sliding scale, let them know what you are able to afford for therapy. They will then tell you if they are able to accommodate that amount within the sliding scale that they offer.

Feeling nervous about this conversation?

We get it. Talking about money can be hard!

Even with friends and loved ones, conversations about finances can be uncomfortable and even embarrassing. It’s natural if you’re feeling unsure about your own willingness or ability to initiate an inquiry about sliding scale.

This is an important part of the process, and we’d love to help ease some of the stress through some recommendations below.

Considerations to help ease your nerves

Therapists are people, too, so it is likely that they’ll be empathetic about the discomfort you might feel talking about money with them and being transparent about your income. Like we said above, talking about money can be hard!

We’re confident you won’t be the first client the therapist has had this type of conversation with. It’s part of the work that they do. Use this conversation to practice being vulnerable and open with another human being, something you’ll most definitely get the opportunity to work more on later, in therapy.

If you’ve taken the leap to try something new and have been courageous to get on the phone with a prospective therapist, you have already surpassed a myriad of obstacles to treatment. Be proud of that. Honor the work you’ve already done, and continue chipping away at the search -- you’re almost there. If you’re able to invest in therapy, and have made the decision to do so, being transparent with the therapist about the amount you’re able to pay is helping them to help you continue forward in your effort towards wellbeing.

Final thoughts

When thinking about your investment in therapy, it’s important to strike a balance between honesty with yourself about what you can afford and respect for the therapist’s fee and value as much as possible.

At the same time, this is one of many opportunities, as challenging as we know it can be, to advocate for what you need. Ensure you are setting yourself up for a relationship, particularly in this context from a financial perspective, that is sustainable and supportive.

It’s worth noting, as well, this time is for you, and you are worth it. Sometimes, our biggest obstacle when thinking about fee is that we aren’t yet sold that we ourselves deserve an hour per week to talk about ourselves.

Let us share a resounding: You do. If you can afford to invest in therapy, we can assure you, it is well worth it and more.

I hope that the information above has helped you to better understand what is meant by the term “sliding scale.”

If you’re a therapy-seeker who can benefit from a sliding scale fee, may you feel empowered and knowledgeable about how to talk to your prospective therapist about this topic during your next phone consultation.

If you have thoughts, comments, or suggestions based on what you’ve read, we’d love to hear from you. Reach out to our team any time at connect@mywellbeing.com or on social @findmywellbeing. If there is a topic you are thinking about or would love more feedback on, let us know! We’re happy to help.

As always, if you’re ready to get started with your therapist match, share your preferences here to receive your match, right to your inbox.